WARRIOR CARE AND TRANSITION SPIRITUAL ASSESSMENT Authority: Principle Purpose: Routine Uses: Disclosure: DATA REQUIRED BY THE PRIVACY ACT OF 1974 United States Constitution, First Amendment; Title X, United States Code (USC), sections 3073, 3547, 5142, and 8067; and DoD Directive 1300.17. To self-report any meaningful spiritual beliefs and practices in order to assist Occupational Therapists (OTs) in developing meaningful spiritual goals as part of the Army s Comprehensive Soldier Fitness (CSF) model to demonstrate that this is nested with the greater CSF program, and as a part of the Warrior Care and Transition's Comprehensive Transition Plan (CTP), all the while providing the utmost respect of each Soldier s personal belief system. For the assessment of spiritual beliefs and practices. Answers provide basis for spiritual goal setting as part of the CTP for each Warrior-in- Transition. Disclosure is voluntary, however failure to disclose may impede OTs ability to assist in developing meaningful spiritual goals as part of the CTP process. 1. If I had to describe what spirituality looks like to me, I would describe it like this Instructions: Please circle how much you agree or disagree with the following statements using the scale below. 2. My spiritual beliefs give meaning to my life s joys and sorrows.
3. My understanding of God or higher power is that (please circle the answer that best reflects your beliefs) A He/she exists and is best understood as my particular religious faith defines him/her. B God exists, but no religion is 100% right about what God is like. C God exists, but I am angry at God and really want nothing to do with him/her. D God may exist, but I m not sure. E I don t believe that God exists. 4. My understanding of God or my spirituality contributes to or influences my goals in life. 5. Without a sense of spirituality, my daily life would be meaningless. 6. The meaning in my life comes from feeling connected to other people or living things. 7. My religious beliefs help me find a purpose in even the most painful and confusing events in my life. 8. When I lose touch with God, I have a harder time feeling that there is purpose and meaning in life.
9. My spiritual beliefs give my life a sense of significance and purpose. 10. Certain spiritual rituals, (i.e. prayer, reading sacred texts, lighting candles, taking communion, etc.) help me to connect with my spiritual side. 11. My mission in life is guided/shaped by my faith in God. 12. When I am disconnected from the spiritual dimension of my life, I lose my sense of purpose. 13. My relationship with God helps me find meaning in the ups and downs of life. 14. My life is significant because I am part of God s plan.
15. What I try to do in my daily life is important to me from a spiritual point of view. 16. I am trying to fulfill my God-given purpose in life. 17. Knowing that I am a part of something greater than myself gives meaning to my life. 18. Looking at the most troubling or confusing events from a spiritual perspective adds meaning to my life. 19. My purpose in life reflects what I believe God wants for me. 20. Without my religious foundation, my life would be meaningless.
21. My feelings of spirituality add meaning to the events in my life. 22. God plays a role in how I choose my path in life. 23. My spirituality helps define the goals I set for myself. 24. Speaking with a minister of my faith or a chaplain encourages me. Please complete the following sentences in your own words. 1. No matter how bad things get, I feel most at peace when I 2. gives me hope.
3. If God were standing here, the one thing I would like to tell God is Multiple Choice Answers in Spiritual Assessment Adapted From Pargament, Kenneth I. Meaning. Multidimensional Measurement of Religiousness/Spirituality for Use in Health Research: A Report of the Fetzer Institute/ National Institute on Aging Working. Kalamazoo, MI: Fetzer Institute, 2003; 19-24. Permission for use granted in the Multidimensional Measurement of Religiousness/Spirituality for Use in Health Research: A Report of the Fetzer Institute/ National Institute on Aging Working.